What is advanced sleep
phase syndrome?
Advanced sleep phase
syndrome is a disorder in which the major sleep episode is
advanced in relation to the desired clock-time, that
results in symptoms of compelling evening sleepiness, an
early sleep onset, and an awakening that is earlier than
desired.
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What are the symptoms?
- Inability to stay awake
until the desired bedtime or inability to remain asleep
until the desired time of awakening
- There is a phase advance
of the major sleep episode in relation to the desired time
for sleep
- Symptoms are present for
at least 3 months
- When not required to
remain awake until the later bedtime, patients will:
- Have a habitual sleep
period that is of normal quality and duration, with a
sleep onset earlier than desired
- Awaken spontaneously
earlier than desired
- Maintain stable
entrainment to a 24-hour sleep-wake pattern
There is a chronic
inability to stay awake in the evening or sleep later into
the morning hours.
The major complaint may
concern either the inability to stay awake in the evening,
or early morning awakening insomnia, or both.
Unlike other sleep
maintenance disorders, the early morning awakening occurs
after a normal amount of undisturbed sleep.
Unlike other causes of
excessive sleepiness, daytime school or work activities
are not affected by sleepiness. However, the evening
activities are cut short by the need to retire much
earlier than the social norm.
Typical sleep onset times
are between 6 and 8 p.m., and no later than 9 p.m., and
wake times between 1 and 3 a.m., and no later than 5 a.m.
These sleep-onset and wake times occur despite the
patient's best efforts to delay sleep to later hours.
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How does this affect a
person?
There can be negative
personal or social consequences that are due to leaving
activities in the early to mid-evening hours in order to
go to sleep.
Attempts to delay sleep
onset to a time later than usual may result in
embarrassment due to falling asleep during social
gatherings, or more seriously from drowsiness or falling
asleep while driving in the evening.
Individuals with advanced
sleep phase syndrome who attempt to work evening or night
shifts would have difficulty staying awake during the
evening and early morning hours.
If chronically forced to
stay up later for social or vocational reasons, the early
awakening aspect of the syndrome could lead to chronic
sleep deprivation and daytime sleepiness or napping.
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Who gets advanced sleep
phase syndrome?
It is more likely to
appear in the elderly.
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How is it treated?
Advanced sleep phase
syndrome is treated with chronotherapy or bright light
therapy. Chronotherapy would involve a systematic
advancement of bedtime until the desired bedtime is
achieved. Bright light therapy would involve inducing a
phase delay and the light exposure must be in the early
evening. There is not a lot of data about the
effectiveness of light therapy for ASPS.
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